Production of hypertonic urine in the absence of pituitary antidiuretic hormone.
Production of hypertonic urine in the absence of pituitary antidiuretic hormone.
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在缺乏垂体抗利尿激素的情况下产生高渗尿。
DOI：
10.1172/jci103541
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发表时间：
1957
期刊：
影响因子：
--
通讯作者：
D. G. Davidson
中科院分区：
文献类型：
--
作者：
R. Berliner;D. G. Davidson
垂体抗利尿激素（ADH）产生肾作用的机制尚未明确。在一般情况下，在没有ADH的情况下，大量产生浓度大大低于血浆浓度的尿液。随着ADH剂量的增加，无论是给药还是分泌，尿液的渗透压都会上升到并高于血浆的渗透压。就总水平衡而言，在数量上对水经济的更重要贡献是最大稀释尿和等渗尿之间的变化，因为在正常人中，这可能涉及每分钟超过10毫升的水排泄变化。由于高渗尿液的精化而进一步节约的水相对较少，按通常的溶质排泄率计算，每分钟不超过1或2毫升。因此，尽管通常认为ADH的功能是引起高渗尿的排泄，但其更重要的功能可能被更好地定义为防止稀尿的排泄。最近关于垂体后叶提取物对青蛙皮肤影响的研究表明，这些制剂根据渗透压梯度显著降低了该膜对水流的阻力(1)。对青蛙膀胱的观察也表明了这种作用机制(2)。研究类似的作用机制在多大程度上可以解释ADH对尿液浓度的影响似乎是合理的。由于从稀尿到等渗尿的变化明显是在渗透梯度消散的方向上，因此ADH的这种影响很可能归因于
The mechanism by which pituitary antidiuretic hormone (ADH) produces its renal effect has not been clearly established. Under ordinary conditions, in the absence of ADH, urine of a concentration considerably below that of plasma is produced in large volume. With increasing amounts of ADH, administered or secreted, the osmotic pressure of the urine rises to and above that of plasma. With respect to total water balance, the quantitatively more important contribution to water economy is the change between maximally dilute and isotonic urine, since this, in normal man, may involve a change in water excretion in excess of 10 ml. per minute. The further saving of water effected by the elaboration of hypertonic urine is a relatively small one, amounting, at usual rates of solute excretion, to not more than an additional 1 or 2 ml. per minute. Thus, although it is commonly stated that the function of ADH is to cause the excretion of a hypertonic urine, its more important function might be better defined as preventing the excretion of a dilute urine. Recent studies of the effects of posterior pituitary extracts on frog skin have shown that these preparations markedly reduce the resistance of this membrane to the flow of water in response to gradients of osmotic pressure (1). Observations on frog bladder also suggest this mechanism of action (2). It would seem reasonable to examine the extent to which a similar mechanism of action could explain the effects of ADH on the concentration of the urine. Since the change from dilute to isotonic urine is clearly in the direction of the dissipation of an osmotic gradient, this effect of ADH could well be attributed to a change in the